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ANTEX – Catastrophic Hospital Plan – DELAWARE
A comparison of the Catastrophic Hospital Plan offered by ANTEX is detailed out below for both Network and Non-Network coverage.
| Network | Non-Network | |
|---|---|---|
|
||
| Network | See Provider | See Provider |
| Application | Catastrophic Hospital Plan Application | Catastrophic Hospital Plan Application |
| Brochure | Catastrophic Hospital Plan Brochure | Catastrophic Hospital Plan Brochure |
| Copay | N/A | N/A |
| Office Visit | Available for Additional Premium | Available for Additional Premium |
| Deductible | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Coinsurance | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Coinsurance Limit | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Out-of-Pocket Maximum | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Lifetime Maximum | $2,000,000 | $2,000,000 |
| Prescription Drugs | Available for Additional Premium | Available for Additional Premium |
| Emergency Room | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Adult Preventative Care | Mammogram- Reasonable and Customary Charges in excess of $25 for one annual screening per Calendar Year | Catastrophic Hospital Plan |
| Child Preventative Care | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Lab / X-Ray | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Maternity | Only Complications of Pregnancy are covered | Only Complications of Pregnancy are covered |
| Physical Therapy | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Skilled Nursing | Catastrophic Hospital Plan | Catastrophic Hospital Plan |
| Home Health Care | ||
| Mental Health | Not covered. | Not covered. |
| Hospital Care | Subject to Deductible | Subject to Deductible |
| Optional Benefits | Optional Accident Expense Benefit Rider |
Optional Accident Expense Benefit Rider |